Martina Blake

Individual provider Active NPI Behavior Technician · Landover, MD

NPI 1306552013 · NPPES record last updated Jan 25, 2023

Key facts

NPI
1306552013
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
8200 Professional PL Ste 115
Landover, MD 20785-2293
Phone
(866) 727-8274
NPI assigned
Jan 25, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

8200 Professional PL Ste 115
Landover, MD 20785-2293

Mailing address

2550 N Hollywood Way Ste 102
Burbank, CA 91505-5031
Phone (866) 727-8274

Other providers in Landover, MD

All providers in Landover, MD · Behavior Technician in Maryland

Sources for this page

Verify at the official NPI Registry.